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Covered diabetic supplies for Kaiser Permanente Colorado Option plans
Kaiser Permanente Colorado Option plans cover diabetic supplies at a $0 copay, with no deductible or coinsurance. The items below are covered when medically necessary and you get them from your health plan's pharmacies or locations.
For a complete list of diabetic supplies that are available at the pharmacy, review the Colorado Marketplace Formulary. Visit our provider directory to find doctors and locations.
Durable medical equipment (DME) and supplies like insulin pumps and glucose monitors are available through our vendors. Please contact your doctor or endocrinology specialist to discuss which devices and supplies you need. They can enter an authorization request for you. The vendor will then reach out to make sure you get the covered items you need.
Diabetic Related Equipment
| Item | How it's covered | How to obtain it |
|---|---|---|
Omnipod 5 DexG7G6 Intro Gen 5 Kit Omnipod 5 DexG7G6 Pods Gen 5 Omnipod Go Kit Omnipod 5 Pack Omnipod Dash 5 Pack Pods Omnipod 5 G6 Pod Omnipod Dash Intro (Gen 4) Kit Omnipod Classic PDM (Gen 3) Kit Omnipod 5 G6 Pod Intro Kit |
RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy Requires prior authorization review |
V-GO 20 Kit V-GO 30 Kit V-GO 40 Kit |
RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy Requires prior authorization review |
| OneTouch Verio Flex | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy |
| Accu-Chek Guide Me | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy Requires prior authorization review |
| Prodigy Voice, Prodigy Autocode | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy Requires prior authorization review |
| Sensor; invasive (e.g., subcutaneous), disposable, for use with nondurable medical equipment interstitial continuous glucose monitoring system (CGM), one unit = 1 day supply |
Medical Benefit (DME) | Byram Healthcare Requires prior authorization review |
Glucose Monitoring
| Item | How it's covered | How to obtain it |
|---|---|---|
| Home blood glucose monitor | RX Benefit | KP pharmacy or contracted affiliated pharmacy Some monitors may require Prior Authorization Review |
Blood glucose monitor with integrated voice synthesizer Blood glucose monitor with integrated lancing/blood sample |
RX Benefit | KP pharmacy or contracted affiliated pharmacy Some monitors may require Prior Authorization Review |
| Adjunctive, nonimplanted continuous glucose monitor (CGM) or receiver | Medical Benefit (DME) | Byram Healthcare 1-833-752-4737 |
Nonadjunctive, nonimplanted continuous glucose monitor (CGM) or receiver Freestyle Libre 2 receiver Freestyle Libre 3 receiver Dexcom G6 receiver Dexcom G7 receiver |
Medical Benefit (DME) | Byram Healthcare Requires Prior Authorization Review |
| Supply allowance for adjunctive, nonimplanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service | Medical Benefit (DME) | Byram Healthcare Requires Prior Authorization Review |
Supply allowance for nonadjunctive, nonimplanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service Freestyle Libre 2 glucose sensors Freestyle Libre 2 PLUS glucose sensors Freestyle Libre 3 glucose sensors Dexcom G6 glucose sensors Dexcom G7 glucose sensors |
Medical Benefit (DME) | Byram Healthcare Requires Prior Authorization Review |
| Medtronic glucose sensors + transmitter | Medical Benefit (DME) | MiniMed Distribution Corp. 1-800-646-4633 ext. 21095 |
Diabetic Lancets
| Item | How it's covered | How to obtain it |
|---|---|---|
| Lancets for blood glucose monitor | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy |
| Lancets, per box of 100 | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy |
Diabetic Test Strips
| Item | How it's covered | How to obtain it |
|---|---|---|
| Test strips for blood glucose monitor | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy |
| Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy |
| Blood glucose test strips, for dialysis, per 50 strips | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy |
Diabetic Syringes
| Item | How it's covered | How to obtain it |
|---|---|---|
| Syringe with needle, sterile, 1 cc or less | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy |
| Syringe with needle, sterile 2 ccs | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy |
| Syringe with needle, sterile 3 ccs | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy |
| Syringe with needle, sterile 5 ccs or greater | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy |
| Insulin syringes (100 syringes, any size) | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy |
Miscellaneous Diabetic Supplies
| Item | How it's covered | How to obtain it |
|---|---|---|
| Needle-free injection device | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy |
| Replacement battery, alkaline (other than J cell), for use with medically necessary home blood glucose monitor owned by patient | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy |
| Replacement battery, alkaline, J cell, for use with medically necessary home blood glucose monitor owned by patient | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy |
| Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy |
| Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy |
| Urine test or reagent strips or tablets (100 tablets or strips) | RX Benefit | Kaiser Permanente pharmacy or affiliated pharmacy |
| Blood ketone test or reagent strip | RX Benefit |
Kaiser Permanente pharmacy or affiliated pharmacy |
| Platforms for home blood glucose monitor, 50 per box | RX Benefit |
Kaiser Permanente pharmacy or affiliated pharmacy |
| Normal, low, and high calibrator solution/chips | RX Benefit |
Kaiser Permanente pharmacy or affiliated pharmacy |
| Spring-powered device for lancet | RX Benefit |
Kaiser Permanente pharmacy or affiliated pharmacy |
| Tape, non-waterproof, per 18 square inches | Medical Benefit (DME) | MiniMed Distribution Corp. 1-800-646-4633 ext. 21095 |
| Tape, waterproof, per 18 square inches | Medical Benefit (DME) | MiniMed Distribution Corp. 1-800-646-4633 ext. 21095 |
| Adhesive remover or solvent (for tape, cement, or other adhesives), per ounce | Medical Benefit (DME) | MiniMed Distribution Corp. 1-800-646-4633 ext. 21095 |
| Adhesive remover, wipes, any type | Medical Benefit (DME) | MiniMed Distribution Corp. 1-800-646-4633 ext. 21095 |
